Measurement of cyanide levels in chronic hemodialysis patients treated with vitamin B12 supplementation with cyanocobalamin saline

Abstract

Introduction: Vitamin B12 or cobalamin is An essential and important vitamin. This vitamin is essential for cell proliferation (hematopoiesis), the health and maintenance of tissues and the strengthening and improvement of immune and nervous system function. Therefore, prevention of vitamin B12 deficiency is important. Supplemental forms of this vitamin that are used to treat vitamin B12 deficiency include cyanocobalamin, hydroxycobalamin, and methylcobalamin. Hemodialysis patients are advised to take oral supplements of this vitamin due to dietary restrictions and anorexia. Among these oral supplements used in hemodialysis Nephrovitis and Nephrotonic tablets contain adjusted amounts of vitamins and minerals required in dialysis patients. The vitamin B12 form in these supplements is cyanocobalamin. Objective: Evaluating the effects of cyanide and thiocyanate retention in chronic hemodialysis patients treated with vitamin B12 supplementation of cyanocobalamin form. Method: This study was a cross-sectional study that after applying the inclusion and exclusion criteria, 30 hemodialysis patients receiving cyanocobalamin supplement and 30 hemodialysis patients without cyanocobalamin supplementation entered the study. Blood samples were taken from these patients and cyanide and thiocyanate concentrations were measured. Colorimetric methods was used to measure cyanide and thiocyanate. The concentrations and the side effects related to these compounds in the both groups were investigated. Results: Obtained data showed that there was no significant difference (p>0.05) between the cyanide and thiocyanate patients concentration receiving cyanocobalamin B12 supplement in two groups during the study period (at least 3 months). Moreover, there were no complications related to cyanide / thiocyanate accumulation in patients and no side effects were observed. Conclusion: In chronic hemodialysis patients, taking vitamin B12 oral supplements of cyanocobalamin type was not associated with cyanide/ thiocyanate-related side effects.